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脑小血管病的影像学标志物与阿尔茨海默病相关：一项系统评价和荟萃分析。

Imaging markers of cerebral small vessel disease are associated with Alzheimer's disease: a systematic review and meta-analysis.

作者信息

Wu Qi, Zhang Jupeng, Lei Peng, Zhu Xiqi, Huang Changhui

机构信息

Department of Radiology, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China.

School of Testing, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China.

出版信息

Front Aging Neurosci. 2025 Jan 28;17:1498636. doi: 10.3389/fnagi.2025.1498636. eCollection 2025.

DOI:10.3389/fnagi.2025.1498636
PMID:40071121
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11894735/
Abstract

OBJECTIVE

This study aims to assess the correlation between cerebral small vessel disease (CSVD) imaging markers and the risk of Alzheimer's disease (AD) through a systematic review and meta-analysis.

METHODS

In July 2024, two researchers independently conducted a thorough literature search across databases such as PubMed, Embase, Web of Science, and the Cochrane Library. The selected studies investigated the correlations between white matter hyperintensities (WMHs), cerebral microbleeds (CMBs), lacunar infarction (LI), and enlarged perivascular spaces (EPVS) and the risk of AD. The Newcastle-Ottawa Scale (NOS) was employed to assess the risk of bias in the included cohort and case-control studies.

RESULTS

A total of 6,487 articles were identified, with 15 articles meeting the inclusion criteria. Pooled analyses showed that WMHs (HR: 1.38, 95% CI: 1.10-1.74,  = 7,661), CMBs (HR: 1.60, 95% CI: 1.07-2.40,  = 6,567), and EPVS (HR: 1.84, 95% CI: 1.24-2.72,  = 3,045) were associated with an increased risk of AD, with EPVS showing the strongest correlation. LI did not show a statistically significant association with an increased risk of AD (HR: 1.41, 95% CI: 0.98-2.01,  = 4,014).

CONCLUSION

WMHs, CMBs, and EPVS are associated with an elevated risk of AD, whereas LI is considered a potential risk factor. However, additional studies are required to determine the role of CSVD markers in AD progression.

摘要

目的

本研究旨在通过系统评价和荟萃分析评估脑小血管病（CSVD）影像标志物与阿尔茨海默病（AD）风险之间的相关性。

方法

2024年7月，两名研究人员独立对PubMed、Embase、Web of Science和Cochrane图书馆等数据库进行了全面的文献检索。入选的研究调查了白质高信号（WMHs）、脑微出血（CMBs）、腔隙性梗死（LI）和扩大的血管周围间隙（EPVS）与AD风险之间的相关性。采用纽卡斯尔-渥太华量表（NOS）评估纳入的队列研究和病例对照研究中的偏倚风险。

结果

共识别出6487篇文章，其中15篇符合纳入标准。汇总分析显示，WMHs（风险比：1.38，95%置信区间：1.10-1.74，样本量=7661）、CMBs（风险比：1.60，95%置信区间：1.07-2.40，样本量=6567）和EPVS（风险比：1.84，95%置信区间：1.24-2.72，样本量=3045）与AD风险增加相关，其中EPVS的相关性最强。LI与AD风险增加未显示出统计学上的显著关联（风险比：1.41，95%置信区间：0.98-2.01，样本量=4014）。

结论

WMHs、CMBs和EPVS与AD风险升高相关，而LI被认为是一个潜在风险因素。然而，需要更多研究来确定CSVD标志物在AD进展中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8096/11894735/a2967d364cdc/fnagi-17-1498636-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8096/11894735/068276e47589/fnagi-17-1498636-g001.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8096/11894735/764e1c961bb1/fnagi-17-1498636-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8096/11894735/a2967d364cdc/fnagi-17-1498636-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8096/11894735/068276e47589/fnagi-17-1498636-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8096/11894735/0dbfe543ab7c/fnagi-17-1498636-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8096/11894735/4b51ceec5e03/fnagi-17-1498636-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8096/11894735/df2d26d15e55/fnagi-17-1498636-g004.jpg
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